Jin Nam-Chul, Kim Hyun-Soo, Kim Dae-Hyun, Song Young-A, Kim Yeon-Ju, Seo Tae-Jin, Park Sun-Young, Park Chang-Hwan, Joo Young-Eun, Choi Sung-Kyu, Rew Jong-Sun
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Clin Endosc. 2011 Sep;44(1):38-43. doi: 10.5946/ce.2011.44.1.38. Epub 2011 Sep 30.
BACKGROUND/AIMS: Ischemic colitis (IC) is usually a self-limiting disease. But, it can cause necrosis that requires urgent surgical treatment. We sought to evaluate clinical difference in IC patients between medical and surgical treatment groups, and to identify prognostic factors for adverse outcomes.
We conducted a retrospective analysis of clinical characteristics in patients with IC treated in Chonnam National University Hospital between May 2001 and April 2010. A total of 81 patients with IC were enrolled. We classified the patients into two groups-a medical treatment group and a surgical treatment group-and evaluated their clinical features, treatment outcomes and mortality.
Absence of hematochezia, vomiting, abdominal tenderness, abdominal rebound tenderness, heart rate over 90 beats/min, systolic blood pressure less than 100 mm Hg, hyponatremia and increased LDH or serum creatinine level were observed more frequently in surgically-treated patients (p<0.05). Most cases in the medically-treated group resolved without complications (98.3%). But, about half of the cases (52.4%) of the surgically-treated group resolved and the mortality rate was 47.6%.
In patients with ischemic colitis, several clinical factors are associated with surgical treatment. Although IC is often selflimited, our data suggests that special attention and aggressive therapy is warranted in treating these patients.
背景/目的：缺血性结肠炎（IC）通常是一种自限性疾病。但是，它可导致坏死，需要紧急手术治疗。我们试图评估IC患者内科治疗组和外科治疗组之间的临床差异，并确定不良结局的预后因素。
我们对2001年5月至2010年4月在全南大学医院接受治疗的IC患者的临床特征进行了回顾性分析。共纳入81例IC患者。我们将患者分为两组——内科治疗组和外科治疗组——并评估他们的临床特征、治疗结果和死亡率。
便血、呕吐、腹部压痛、腹部反跳痛、心率超过90次/分钟、收缩压低于100 mmHg、低钠血症以及乳酸脱氢酶或血清肌酐水平升高在外科治疗患者中更常见（p<0.05）。内科治疗组的大多数病例无并发症缓解（98.3%）。但是，外科治疗组约一半的病例（52.4%）缓解，死亡率为47.6%。
在缺血性结肠炎患者中，一些临床因素与手术治疗相关。尽管IC通常是自限性的，但我们的数据表明，在治疗这些患者时需要特别关注并采取积极治疗措施。
